Moneyball for Medicine

The Incrementalist Graphic Richard Milani
This week I am talking to Richard Milani, MD, (@rvmilani) Chief Clinical Transformation Officer at Ochsner Health System and Preventative Medicine and Clinical Epidemiologist and Cardiovascular specialist. We met at the HIMSS 2019 AMDIS Pre-Conference: Reengineering Healthcare Delivery through Innovation. His presentation resonated with me as he focused on the importance of the underlying causes and components of disease, the importance of behavior change and addressed the challenge of integrating digital into health.
We discussed the overwhelming challenge of dealing with Chronic disease that is linked to 70% of deaths and 86% of all the healthcare spend with he largest contributor being the individual behaviors and personal choices – exceeding the contribution of healthcare and our genetics.
We currently capture patient interactions infrequently and the data collected is infrequent and of an insufficient data sampling rate to offer a practical and more importantly effective tool to manage the disease.

Incremental Points

  • Acknowledging the fact that what we are doing in healthcare now is not doing a good job and we have to change
  • You don’t have to be an expert to start changing – a recurring theme from other interviews and projects: Don’t let perfection stand in the way of progress
  • Technology is an enabler

You can read much more detail in his book: Death and Dollars: Solving the Epidemic of Chronic Disease
You can hear about the Ochsner clinics version of the Genius Bar (pure genius!)  – The O-Bar (as featured on the Apple Healthcare website) offering patients a digitally curated set of healthcare apps to choose out of the more than 180,000 they can find one at the Apple App Store as well as recommended low friction digital health devices.
Listen in to find out about their successful management of hypertension and why the patient-generated Blood Pressure data is so important and better than that obtained in a clinical office. As he highlighted – 50% of the Hypertensives remain undiagnosed and untreated which is literally killing people.


Listen live at 4:00 AM, 12:00 Noon or 8:00 PM ET, Monday through Friday for the next two weeks at HealthcareNOW Radio. After that, you can listen on demand (See podcast information below.) Join the conversation on Twitter at #TheIncrementalist.


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